I presume she had pain when she first went to the local urgent care center,
but don’t have that information.
The MRI was ordered to evaluate the lesion found on outside XRs.
In addition to the anterior intracortical lesion there seems to be
posterior endosteal stress reaction—white arrows—which I suspect is the
source of her pain.
The question is whether, in a skeletally mature young adult, this is
adamantinoma…or if it can still be considered osteofibrous dysplasia.
In axial T1 there seems to be either marked superficial cortical thinning
or smooth destruction of the outer cortex (not really proved on Ax T2 at
the same level). It avidly enhances (last image is post contrast).
Thanks for your help,
Hilary
[image: 21F tibial lesion.jpg]
[image: 21F tibial lesion (1).jpg]
[image: 21F tibial lesion (2).jpg]
21F-tibial-lesion.pdf